In January 1995 we (Social Service Department) received a referral for an in-patient Mrs. B. Mrs. B was a 56-year-old, African-American female who had been admitted to our facility with a diagnosis of R/O cerebral vascular accident. When first seen, Mrs. B evidenced clear cognitive impairments, including slurred speech, decreased concentration and memory, and tangentiality. The history she was able to provide was sketchy, but did Include the following: Mrs. B was a recent widow, her husband having died in a nursing home from. AIDS 2 weeks prior to admission. She had been diagnosed HIV+ in 1992, when she began hemodialysis for chronic renal failure. She believed she had contracted the virus heterosexually from her husband. She denied any history of substance abuse. Mrs. B had seven adult children, none of whom were aware of her HIV diagnosis. Prior to admission, she was living alone. Prior to 1992 Mrs. B had worked as an office cleaner, and later qualified for Social Security and Medicare benefits. She had once previously been seen in our community mental health clinic for depression, and was treated at a nearby satellite dialysis facility for end-stage renal disease.